[Yes, we should keep ABO agglutination test within bedside transfusion checks].
ABO incompatible transfusions are still a frequent cause of serious adverse transfusion reactions. Bedside check is intended to detect patient errors and prevent ABO mismatch. France is one of the few countries that includes ABO agglutination test for red blood cells in bedside checks. Evaluation of this ABO agglutination test, performed with a special card, shows that, on the field, despite frequent users' mishandling, it can detect up to 93% of ABO incompatibilities. This is not enough to rely on this sole test for bedside checks. But, linking it with an another test, currently, checks that the right blood is given to the right patient, rises the sensitivity of the whole bedside procedure up to an estimated 99.65%, for detection of ABO incompatibilities. This linkage has been introduced in the French regulation in 2003. Since then, the incidence of ABO incompatible transfusions has decreased dramatically and faster than in any other country, so France has now, probably, the lowest rate of ABO incompatible transfusions. The investigation of the few ABO accidents that still occur, shows that professionals have always bypassed this linkage. On the other hand, introducing bedside recipient and blood products barcode or radio-chip checks in all the 1500 French hospitals, though technically possible, would provide very little enhancement and lead to major difficulties and expenses. Linkage of ABO agglutination test to patient and blood checks within the bedside procedure has proved to be efficient and should be kept.
Daurat
G
G
Drass, Parc-Club-du-Millénaire, Montpellier, France. gerald.daurat@sante.gouv.fr
D000017:ABO Blood-Group System / Q000032:analysis; D001787:Blood Group Incompatibility / Q000453:epidemiology / Q000517:prevention & control*; D001788:Blood Grouping and Crossmatching / Q000379:methods / Q000592:standards*; D001803:Blood Transfusion / Q000331:legislation & jurisprudence / Q000592:standards*; D001330:Electronic Data Processing; D004582:Electronics, Medical / Q000295:instrumentation; D005060:Europe / Q000453:epidemiology; D005188:False Negative Reactions; D005189:False Positive Reactions; D005602:France / Q000453:epidemiology; D006386:Hemagglutination Tests; D006801:Humans; D019300:Medical Errors / Q000517:prevention & control*; D010355:Patient Identification Systems; D019095:Point-of-Care Systems / Q000592:standards*; D011792:Quebec / Q000453:epidemiology; D011933:Reagent Kits, Diagnostic; D012189:Retrospective Studies; D012680:Sensitivity and Specificity
D000017:ABO Blood-Group System; D011933:Reagent Kits, Diagnostic